We will get the Health Service (and everything else) we are prepared to pay for

One reason democracy is failing across the Western World (and notably here in Northern Ireland, where we never really took to it in the first place) is that people are inclined to believe the first thing they hear and then refuse to countenance any future evidence to the contrary. Since they also seek out comfortable information which suits existing narratives, this often means that an entirely biased political view becomes entrenched as “fact”. Parties like the DUP and Sinn Féin are very good at this game, introducing their own facts in the knowledge that no matter how much contrary evidence appears, their own supporters will stick to the original.

One example is the notion that problems in the Health Service are solely because of “Tory Austerity”.

Yet for the entire period from May 2010 to March 2017 there was either a DUP or Sinn Féin Health and Finance Minister; and for that entire period Health funding was raised in Northern Ireland by less than it was raised in England by the Tory-led government with a Tory Chancellor and Tory Health Secretary.

Throughout that period, several times a year, a raise in Health spending in England was also allocated proportionate to population to Northern Ireland (known as “Barnett consequentials”). Not once did the DUP/SF-led Executive spend that entire allocation on Health. Indeed, there were occasions where none of it was allocated to  Health – not a penny. Money which was allocated as an uplift to Health spending in England was not so spent in Northern Ireland because the DUP and Sinn Féin opted to spend it on something else.

The same, out of interest, applies to the SNP in Scotland, where rises in Health spending have been much closer to those in Northern Ireland than the much higher rises in England. Scots have begun to realise it and are voting accordingly.

This, in fact, is the crux of the current breakdown in devolution here. Neither the DUP or Sinn Féin is much interested in government. Neither (particularly the latter) will ever tell you honestly that you will get the Health Service (and any other service) you are prepared to pay for.

The NI Health Service is not a disaster, by the way. Many aspects of it are quite good. However, the idea that we have a universal service free at point of access is no longer meaningfully true in some areas. It needs serious reform to fix this but even if the reform proceeds smoothly (which it surely won’t as it is extraordinarily complex) there still is not enough money to run a universal service for everyone free at point of access across all services from taxes and rates alone (as they currently are).

In the end, we need to get away from the ludicrous notion that the Health Service or indeed any other public service is “free”. Actually, it all has to be paid for. We then need room for an honest, coherent and open debate about how we will pay for it. Silly slogans are not going to do it, particularly when they are profoundly inaccurate.


One thought on “We will get the Health Service (and everything else) we are prepared to pay for

  1. William Harrison says:

    Well said. An honest account of where we are. We the the great unwashed would welcome a suggestion on how to resolve these issues. Is it maybe a new COMMONSENSE party, the introduction of water rates, or maybe both?

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